Hyaluronic Acid (HA) is an essential component of tissue
extracellular matrices that contributes to the architecture of
stem cell niches, which determine the fate of stem cells. Decreased levels of HA are found in subjects experiencing a variety of
pathological conditions, as well as in subjects receiving a variety of therapeutic interventions, for example,
chemotherapy or radiotherapy, to treat
pathological conditions. The use of HA to reconstitute a tissue
extracellular matrix partially or completely depleted of HA is described. More particularly, described herein is the use of exogenous forms of HA as an
adjuvant in the restoration of the local
tissue specific stem cell microenvironment to enhance
stem cell recovery or engraftment and thus tissue
recovery and remodeling following stem
cell transplantation or other therapies. The effect of HA on hematopoietic stem cells is illustrative of the invention. Mice having severe
bone marrow hypoplasia, and pancytopenia resulting from treatment with 5-
fluorouracil recovered more rapidly if treated with HA. Similarly, mice transplanted with hematopoietic stem cells following lethal
irradiation exhibited
enhanced recovery of
peripheral blood cell counts when treated with HA as an
adjuvant therapy compared to control mice transplanted with hematopoietic stem cells without
adjuvant therapy.